Early outcomes of an integrated hepatology–addiction medicine group medical visit model for alcohol-associated liver disease

Abstract Background: Effective management of alcohol-associated liver disease (ALD) requires treatment of coexisting alcohol use disorder (AUD); however, <5% of patients receive evidence-based AUD pharmacotherapy in routine care. We evaluated early outcomes of an interdisciplinary group medical visit (GMV) clinic integrating hepatology, addiction medicine, and peer support in patients with ALD. Methods: We conducted a retrospective observational study of adults with ALD who attended an interdisciplinary GMV clinic at a tertiary care centre in Winnipeg, Manitoba, Canada, between January 2023 and April 2025. Outcomes included AUD treatment uptake, clinic engagement, alcohol use outcomes, and acute care utilization. Exploratory analyses examined outcomes by level of clinic engagement. Results: Of 112 patients scheduled, 70 (62.5%) attended at least one GMV and formed the analytic cohort (median age: 53 years; 62% male). Alcohol-associated cirrhosis was present in 69%, with decompensation in 65% and severe AUD in 61%; 85% of participants engaged in AUD treatment. Pharmacotherapy uptake increased from 32% pre-clinic to 71% following GMV participation ( p < 0.001), most commonly with naltrexone. Among patients who completed ≥3 GMVs (n = 32), 62.5% achieved abstinence at approximately 6 months. Abstinence at 6 months was higher among patients who attended ≥2 GMVs than among those who attended a single visit (52.6% versus 0%; p < 0.001). Acute care utilization declined by ∼67%, with reductions in emergency department visits and in-patient admissions. Conclusions: A GMV-based interdisciplinary model for ALD was associated with increased initiation of AUD pharmacotherapy, favourable early alcohol use outcomes, and reduced acute care utilization.